![]() ![]() However, the role is not as clinically important as compared with the shortening of the radius. 39, 40 Possible dorsal angulation may also have an effect on functional outcome. In addition, over 2 mm step-off or gap may also cause similar problems in elderly patients. 40, 41 It seems, however, that over 1 mm step-off or gap on the joint line significantly increases the risk of secondary osteoarthritis and may cause prolonged pain and stiffness in younger patients. ![]() 36– 39 In younger patients, a shortening of the radius of more than 3 mm may cause functional deficit in terms of prolonged pain, reduced range of motion (ROM) and decreased grip strength. Shortening of the radius, articular step-off and gap in the joint line are the most significant radiological predictors of poor functional outcome. Radiological factors that predict functional outcome However, with Colles’ fracture, there is no classification to help in predicting instability. Smith’s and Barton’s fractures are generally considered to be unstable, warranting operative treatment in most cases. These classifications can help to distinguish between different fracture patterns. In clinical practice, fractures are commonly classified as Colles’ fracture ( Fig. However, the utility of these in clinical practice is modest since patient characteristics, such as age, are not taken into account. Articular surface unity and fracture comminution are important factors in these classification systems. These classification systems are commonly based on radiographs, fracture pattern and injury mechanism. Several classification systems, such as the AO and Fernandez and Frykman classifications 20– 22 exist for DRFs. 15– 17 If injury of the carpal ligaments is suspected, CT or high-resolution magnetic resonance imaging may be beneficial before a final treatment decision is made. ![]() Soft tissue injuries have been shown to be present in approximately 31% of cases, 15 and they may have an effect on treatment decisions. 13, 14 The clinical examination of soft tissues in the wrist and hand is also important. However, computed tomography (CT) 13 may yield additional benefits in evaluating the articular surface and comminution of the fracture, which may be a risk factor for osteoarthritis of the radiocarpal joint. The gold standard in DFR diagnostics is anterior-posterior and lateral radiographs. ![]()
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